Mod Squad Diabetes Camp Tuition Grant Application

T1D Mod Squad takes pride in being able to give grants to T1D kids who need an assistance dog.

Parent's Name

Child's Name

Home Address

How long have you been a member of T1D Mod Squad?

Name of DAD service company you will be using:

Name of company contact:

Telephone No.

Cost of DAD:

Amount of funds raised:

Your Email

T1D Mod Squad takes pride in being able to give grants to T1D kids who need an assistance dog.

1. In a few words, please explain why you decided to apply for the T1D DAD grant and how do you plan on paying the rest of the costs.

2. In a few words, please describe why you feel your child needs a DAD. If your child is older than 8 yrs of age, please have your child answer.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Disclaimer:

We do not share any information from this form.
Any false information by applicant will be immediate grounds for dismissal from consideration to receive a grant from T1D Mod Squad.
The amount of the grant received will only cover a portion of the total cost of the DAD. You will be responsible for the rest of the cost.
Please understand if your child is chosen, the funds will be directly deposited to the DAD service company.

Diabetic Alert Dog Grant Application